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For about a year Frosty's vets have been saying they really think he has Cushing's. I haven't been completely convinced based on all the papers from vet schools I've read online. He does have some symptoms, but those same symptoms are also evident in dogs his age. Here is a list of symptoms from an article by Kate Connick called "Pet Owner's Crash Course in Canine Cushing's Disease".
Symptoms: Symptoms of Cushing's disease can be vague and varied and tend to appear gradually and progressively. It is thus easy to mistake Cushing's disease for normal aging. Additionally, many of the clinical symptoms are not unique to Cushing's and could reflect a number of other health concerns.

The most common symptoms include:
• increased/excessive water consumption (polydipsia)
• increased/excessive urination (polyuria)
• urinary accidents in previously housetrained dogs
• increased/excessive appetite (polyphagia)
• appearance of food stealing/guarding, begging, trash dumping, etc.
• sagging, bloated, pot-bellied appearance
• weight gain or its appearance, due to fat redistribution
• loss of muscle mass, giving the appearance of weight loss
• bony, skull-like appearance of head
• exercise intolerance, lethargy, general or hind-leg weakness
• new reluctance to jump on furniture or people
• excess panting, seeking cool surfaces to rest on
• symmetrically thinning hair or baldness (alopecia) on torso
• other coat changes like dullness, dryness
• slow regrowth of hair after clipping
• thin, wrinkled, fragile, and/or darkly pigmented skin
• easily damaged/bruised skin that heals slowly
• hard, calcified lumps in the skin (calcinosis cutis)
• susceptibility to infections (especially skin and urinary)
• diabetes, pancreatitis, seizures

He has almost all those except the last 4, to some small degree at least. He also has low thyroid, which can be a symptom of Cushing's or a problem on it's own. It was treated for several months and never did get up to where it should on the med. It got to 2.3 on 0.1 mg per day. He's been off now for about 6 mo. and it is .5--but they don't want to put him back on it.???

He does have elevated liver enzymes--gone up double the last 6 mo. (I don't have the numbers, but have requested copies of all his lab work). His urine Cortisol/Creatinine ratio was 14 6 mo. ago (borderline). Yesterday they did a ACTH Cushing's test. It was negative. They only drew once after the injection, 1 hour after. The test isn't very definitvie, possibly 40% inaccurate. He had to be off the Anipryl he had been taking for 3 mo. for a month before the test, and has started to be almost as aggressive as he was before taking it. They said to put him back on 5 mg. Anipryl. They could do a Low Dose Dexamethasone Suppression Test, but that's another $165. and isn't much better than the one we just did. I don't really want to put him on the other Cushing's drug (Lysodren), it is really dangerous especially in an elderly dog, and requires constant blood tests to make sure of the dosage. The Anipryl will only help the Cushing's if it is pituitary and not if it is adrenal. However, it is helpful for elderly dogs with cognitive problems and did seem to help him some. It not only helped the aggressiveness, but his thinning hair grew in thicker. It didn't help the water consumption and urine accidents. There is one other drug, Ketaconazole, which could be given and helps about 80% of dogs with either adrenal or pituitary tumors. I don't know why it hasn't been mentioned by my vets. Maybe because we still don't have a good diagnosis?

I'm feeling like there is no answer here, and I don't really know what I should be doing. At almost 14 should I keep testing and treating or just take good care of him diet wise and hope for the best? As far as I know there isn't a down side to giving him the Anipryl, other than the cost of almost $60. a mo. I can do that! There is not "cure" for Cushing's. Quote from above article: "Cushing's disease is not something from which a dog recovers. Cushing's disease is managed, not cured. Whether treated or not, most dogs will die within a few years of diagnosis, although not necessarily due to Cushing's iteself. Again, that is because most Cushing's patients are elderly and have concurrent health issues."

I would be grateful for any advice from the professionals out there that have knowledge in canine medicine.
 

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anipryl isnt the best drug for cushings...it hardly ever works....but it is good for the mentation thing..so im glad it is helping in that sense....they teach us to do the low dose dex test first (will diagnose 95% of cases)...or to do cortisol/creatinine ratio to rule it out...wont rule it in. acth stim diagnoses 85%pituitary and 60% adrenal...that is why we recommend the low dose dex first.

but if u r not willing to go on lysodren or Trilostane ...there really is no point in testing him....didnt u say he had been on steroids a lot when younger?
 

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Discussion Starter · #3 ·
Originally posted by LadyMontava@Nov 10 2005, 07:34 PM
but if u r not willing to go on lysodren or Trilostane ...there really is no point in testing him....didnt u say he had been on steroids a lot when younger?
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It's the Lysodren I'm afraid of. No one has mentioned giving Trilostane. I thought it was taken off the US market. The last I heard it is only available in England.

Frosty was given drugs with pregnisone (sp) several times when he was young for skin problems related to allergies. The vet also had me use cortisone shampoo, spray, etc. for several years. He hasn't had any for probably 7-8 years. The vets seem to think it isn't related to his Cushing's symptoms.
 

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1. Thyroid dysfunction can secondarily cause liver values to be up. Why aren't they treating him for hypothyroidism? I would want a thyroid panel sent to MSU, not just a T4.

2. Treating Cushing's does not increase a dog's lifespan. If you are comfortable with his symptoms and are not planning to treat, why do the LDDS? If you do want to treat, I would do that test and also have an abdominal u/s to be sure there are no adrenal tumors just to be thorough.

3. If the Anipryl helps him, I would stick with it. The generic name is selegeline. You might see if you can get the generic a bit cheaper.
 

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i would just let him be and keep him on anipryl since that is helping the aggression...just keep him happy.
 
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